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Policy Analysis No. 545

Treating Doctors as Drug Dealers: The DEA’s War on Prescription Painkillers

By
Ronald T. Libby

June 6, 2005

Executive Summary

The medical field of treating chronic pain is still in its
infancy. It was only in the late 1980s that leading physicians
trained in treating the chronic pain of terminally ill cancer
patients began to recommend that the “opioid therapy”(treatment
involving narcotics related to opium) used on their patients also
be used for patients suffering from non terminal conditions. The
new therapies proved successful, and prescription pain medications
saw a huge leap in sales throughout the 1990s. But opioid therapy
has always been controversial. The habit-forming nature of some
prescription pain medications made many physicians, medical boards,
and law enforcement officials wary of their use in treating acute
pain in non terminal patients. Consequently, many physicians and
pain specialists have shied away from opioid treatment, causing
millions of Americans to suffer from chronic pain even as therapies
were available to treat it.

The problem was exacerbated when the media began reporting that
the popular narcotic pain medication OxyContin was finding its way
to the black market for illicit drugs, resulting in an outbreak of
related crime, overdoses, and deaths. Though many of those reports
proved to be exaggerated or unfounded, critics in Congress and the
Department of Justice scolded the U.S.Drug Enforcement
Administration for the alleged pervasiveness of OxyContin
abuse.

The DEA responded with an aggressive plan to eradicate the
illegal use or “diversion” of OxyContin. The plan uses familiar law
enforcemet methods from the War on Drugs, such as aggressive
undercover investigation, asset forfeiture, and informers. The
DEA’s painkiller campaign has cast a chill over the doctor-patient
candor necessary for successful treatment. It has resulted in the
pursuit and prosecution of well-meaning doctors. It has also scared
many doctors out of pain management altogether, and likely
persuaded others not to enter it, thus worsening the already
widespread problem of underrated untreated chronic pain.